Pavo Primary Care Clinic

LBN: John D. Archbold Memorial Hospital, Inc.
Pavo Primary Care Clinic is an health care organization with primary practice located at 1103 North Main Street , Pavo GA 31778. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. John D. Archbold Memorial Hospital, Inc. can be contacted via phone (229) 859-2622, or through Hightower, Charles D. via phone (229) 228-2853.

Contact Information

Primary practice address
1103 North Main Street Pavo GA 31778
Fax: (229) 859-2885
Website:
Authorized official contact:
Name: Hightower, Charles D.

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X 136-91 Georgia

Profile Details

NPI number 1932296811
LBN Legal business name John D. Archbold Memorial Hospital, Inc.
DBA Doing business as Pavo Primary Care Clinic
Authorized official Hightower, Charles D.
Entity Organization
Organization subpart 1 No
Enumeration date Oct 10th, 2006
Last updated May 7th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932296811 NPPES
Georgia MEDICAID 000000063H

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